Provider Demographics
NPI:1194234153
Name:CHASE, MICHAELA N (PLMHP)
Entity type:Individual
Prefix:MS
First Name:MICHAELA
Middle Name:N
Last Name:CHASE
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 N COTNER BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2377
Mailing Address - Country:US
Mailing Address - Phone:402-937-9607
Mailing Address - Fax:844-848-7537
Practice Address - Street 1:770 N COTNER BLVD STE 330
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2377
Practice Address - Country:US
Practice Address - Phone:402-937-9607
Practice Address - Fax:844-848-7537
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health